Universidade Federal Fluminense - Departamento de Epidemiologia e Bioestatística, Niterói, RJ - Brasil.
Universidade Federal Fluminense Faculdade de Medicina - Departamento de Radiologia, Niterói, RJ - Brasil.
Arq Bras Cardiol. 2021 Apr;116(4):763-771. doi: 10.36660/abc.20190742.
Cardiovascular disease (CVD) mortality, after several decades of decrease, has shown a tendency towards the stabilization in some countries, including Brazil and Rio de Janeiro state. This new tendency was not further analyzed by gender, age group and region of the Rio de Janeiro state.
To analyze the trends of premature and late mortality from CVD, ischemic heart disease (IHD) and cerebrovascular disease (CBVD) by gender in the city of Rio de Janeiro (capital) and the health regions of Rio de Janeiro state (from 1996 to 2016.
Data on deaths and the population were obtained from DATASUS/MS. The rates were compensated by ill-defined codes, corrected by Ill-Defined Cardiovascular codes and gender and age-adjusted by the direct method (reference population - population of the state of Rio de Janeiro - 2000 census). The Joinpoint Trend Analysis Software was employed.
IHD mortality stabilized or even increased for at least 50% of the analyzed areas (EAPC≥0). No change was observed. in the "North" and "Northwest" regions For CBVD, just one region showed stability regarding mortality (EAPC close to 0). For the other regions, the rate continued to decrease (APC<0) until 2016.
These results observed in Rio de Janeiro are possibly appropriate to various Brazilian regions and demonstrate that a serious public health response is needed to address lifestyle behaviors. Primary care physicians should also be familiar with the unfavorable tendency in coronary heart disease among younger adults in recent years and actively screen for risk factors for cardiovascular disease, paying special attention to women.
心血管疾病(CVD)死亡率在经历了几十年的下降后,在一些国家(包括巴西和里约热内卢州)出现了稳定的趋势。这种新趋势尚未按性别、年龄组和里约热内卢州地区进行进一步分析。
分析里约热内卢市(首府)和里约热内卢州各卫生区(1996 年至 2016 年)按性别划分的 CVD、缺血性心脏病(IHD)和脑血管疾病(CBVD)过早和晚期死亡率的趋势。
死亡率和人口数据来自 DATASUS/MS。采用未明确定义的代码进行速率补偿,用未明确定义的心血管代码进行校正,并通过直接法(参考人群-里约热内卢州人口-2000 年普查)进行性别和年龄调整。采用 Joinpoint 趋势分析软件进行分析。
至少 50%的分析区域 IHD 死亡率稳定或甚至增加(EAPC≥0)。“北部”和“西北部”地区未观察到变化。对于 CBVD,只有一个地区的死亡率保持稳定(EAPC 接近 0)。对于其他地区,死亡率持续下降(APC<0),直到 2016 年。
在里约热内卢观察到的这些结果可能适用于巴西的各个地区,并表明需要采取严肃的公共卫生措施来解决生活方式行为。初级保健医生还应熟悉近年来年轻成年人冠心病的不利趋势,并积极筛查心血管疾病的危险因素,特别要关注女性。